Contract Details
Ancillary Care Services
Facility name
Imaging El Paso
Provider ID
P000004972
NPI
1629184361
Tax ID
050565644
Effective Date
4/1/2012
Last Updated
10/22/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
68.00
Location Details
Address
2930 North Stanton Street
El Paso, TX 79902
United States
County
El Paso
Phone
9155452273 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Diagnostic Services
Map
Address